Top

Published in:

Open Access 01-12-2021 | Central Nervous System Trauma | Research article

Noninvasive real-time assessment of intracranial pressure after traumatic brain injury based on electromagnetic coupling phase sensing technology

Authors: Gen Li, Wang Li, Jingbo Chen, Shuanglin Zhao, Zelin Bai, Qi Liu, Qi Liao, Minglian He, Wei Zhuang, Mingsheng Chen, Jian Sun, Yujie Chen

Published in: BMC Neurology | Issue 1/2021

Abstract

Background

To investigate the feasibility of intracranial pressure (ICP) monitoring after traumatic brain injury (TBI) by electromagnetic coupling phase sensing, we established a portable electromagnetic coupling phase shift (ECPS) test system and conducted a comparison with invasive ICP.

Methods

TBI rabbits’ model were all synchronously monitored for 24 h by ECPS testing and invasive ICP. We investigated the abilities of the ECPS to detect targeted ICP by feature extraction and traditional classification decision algorithms.

Results

The ECPS showed an overall downward trend with a variation range of − 13.370 ± 2.245° as ICP rose from 11.450 ± 0.510 mmHg to 38.750 ± 4.064 mmHg, but its change rate gradually declined. It was greater than 1.5°/h during the first 6 h, then decreased to 0.5°/h and finally reached the minimum of 0.14°/h. Nonlinear regression analysis results illustrated that both the ECPS and its change rate decrease with increasing ICP post-TBI. When used as a recognition feature, the ability (area under the receiver operating characteristic curve, AUCs) of the ECPS to detect ICP ≥ 20 mmHg was 0.88 ± 0.01 based on the optimized adaptive boosting model, reaching the advanced level of current noninvasive ICP assessment methods.

Conclusions

The ECPS has the potential to be used for noninvasive continuous monitoring of elevated ICP post-TBI.

Available only for authorised users

Ren, J., Wu, X., Huang, J., et al. Intracranial pressure monitoring-aided management associated with favorable outcomes in patients with hypertension-related spontaneous Intracerebral hemorrhage. Transl Stroke Res 2020. https://doi.org/https://doi.org/10.1007/s12975-020-00798-w.

Wu, J., He, J., Tian, X., Zhong, J., Li, H. & Sun, X. Activation of the hedgehog pathway promotes recovery of neurological function after traumatic brain injury by protecting the neurovascular unit. Transl Stroke Res 2020. https://doi.org/https://doi.org/10.1007/s12975-019-00771-2.

Chodobski, A., Zink, B.J. & Szmydynger-Chodobska, J. Blood–brain barrier pathophysiology in traumatic brain injury. Transl Stroke Res 2011;2:492–516. https://doi.org/https://doi.org/10.1007/s12975-011-0125-x.

Giraudet F., Longeras F. & Mulliez A. Noninvasive detection of alarming intracranial pressure changes by auditory monitoring in early management of brain injury: a prospective invasive versus noninvasive study. Crit Care 2017;21:35. https://doi.org/https://doi.org/10.1186/s13054-017-1616-2.

Griffiths H., Stewart W. R. & Gough W. Magnetic induction tomography: a measuring system for biological tissues. Ann N Y Acad Sci 1999; 873, 335–345. https://doi.org/https://doi.org/10.1111/j.1749-6632.1999.tb09481.x.

Scharfetter H., Casañas R. & Rosell J. Biological tissue characterization by magnetic induction spectroscopy (MIS): requirements and limitations. IEEE Trans Biomed Eng 2003;50:870–880. https://doi.org/https://doi.org/10.1109/TBME.2003.813533.

González C. A. & Rubinsky B.. The detection of brain oedema with frequency-dependent phase shift electromagnetic induction. Physiol Meas 2006;27:539–552. https://doi.org/https://doi.org/10.1088/0967-3334/27/6/007.

Sun J., Jin G., Qin M. X., et al. Detection of acute cerebral hemorrhage in rabbits by magnetic induction. Brazilian Journal of Medical & Biological Research 2014;47:144–150. https://doi.org/https://doi.org/10.1590/1414-431X20132978.

Zhao S., Li G., Gu S., et al. An experimental study of relationship between magnetic induction phase shift and brain parenchyma volume with brain edema in traumatic brain injury. IEEE Access. 2019;7:20974–20983. https://doi.org/https://doi.org/10.1109/ACCESS.2019.2897609.

10.

Li G., Chen J., Yang J., et al. Dual parameter synchronous monitoring system of brain edema based on the reflection and transmission characteristics of two-port test network. IEEE Access 2019;7: 50839–50848. https://doi.org/https://doi.org/10.1109/ACCESS.2019.2911178.

11.

Gabriel C., Gabriel S. & Corthout E. The dielectric properties of biological tissues: I. literature survey. Phys Med Biol 1996;41(11):2231–2249. https://doi.org/https://doi.org/10.1088/0031-9155/41/11/001.

12.

Li G., Ma K., Sun J., et al. Twenty-four-hour real-time continuous monitoring of cerebral edema in rabbits based on a noninvasive and noncontact system of magnetic induction. Sensors. 2017;17:537. https://doi.org/https://doi.org/10.3390/s17030537.

13.

Guo P., Luo H. & Fan Y. Establishment and evaluation of an experimental animal model of high altitude cerebral edema. Neurosci Lett 2013;547:82–86. https://doi.org/https://doi.org/10.1016/j.neulet.2013.05.008.

14.

Yang J., Zhao H., Li G., et al. An experimental study on the early diagnosis of traumatic brain injury in rabbits based on a noncontact and portable system. PeerJ. 2019;7:e6717. https://doi.org/https://doi.org/10.7717/peerj.6717.

15.

Li G., Sun J., Ma K., et al. Construction of a cerebral hemorrhage test system operated in real-time. Sci Rep 2017;7:42842. https://doi.org/https://doi.org/10.1038/srep42842.

16.

Sun J., Chen J., Li G., et al. A Clinical Research on Real-time Monitoring of Cerebral Edema after Basal Ganglia Hemorrhage Based on Near-field Coupling Phase shift Technology. IEEE Access. 2019; 7:123736–123745. https://doi.org/https://doi.org/10.1109/ACCESS.2019.2938812.

17.

Shields, J., Kimbler, D.E., Radwan, W. et al. Therapeutic targeting of astrocytes after traumatic brain injury. Transl Stroke Res 2011;2:633–642. https://doi.org/https://doi.org/10.1007/s12975-011-0129-6.

18.

Hawthorne C. & Piper I. Monitoring of intracranial pressure in patients with traumatic brain injury. Front Neurol 2014; 5:121. https://doi.org/https://doi.org/10.3389/fneur.2014.00121.

19.

Sorrentino E., Diedler J., Kasprowicz M. Critical thresholds for cerebrovascular reactivity after traumatic brain injury. Neurocrit Care 2012;16:258–266. https://doi.org/https://doi.org/10.1007/s12028-011-9630-8.

20.

Petkus V., Preiksaitis A., Chaleckas E., et al. Optimal cerebral perfusion pressure: targeted treatment for severe traumatic brain injury. J Neurotrauma 2020;37(2):389–396. https://doi.org/https://doi.org/10.1089/neu.2019.6551.

21.

Alperin N., Lee S., Loth F., Raksin P.B. & Lichtor T. MR-intracranial pressure (ICP): a method to measure intracranial elastance and pressure noninvasively by means of MR imaging: baboon and human study. Radiology. 2000;217(3):877–885.https://doi.org/https://doi.org/10.1148/radiology.217.3.r00dc42877.

22.

Behrens A., Lenfeldt N., Ambarki K., et al. Transcranial Doppler Pulsatility index: not an accurate method to assess intracranial pressure. Neurosurgery. 2010; 66(6):1050–1057. https://doi.org/https://doi.org/10.1227/01.NEU.0000369519.35932.F2.

23.

Zweifel C., Czosnyka M., Carrera E., et al. Reliability of the blood flow velocity Pulsatility index for assessment of intracranial and cerebral perfusion pressures in head-injured patients. Neurosurgery. 2012;74(4):853–861. https://doi.org/https://doi.org/10.1227/NEU.0b013e3182675b42.

24.

Wang T., Ma S., Guan Y., et al. Double function of noninvasive intracranial pressure monitoring based on flash visual evoked potentials in unconscious patients with traumatic brain injury. J Clin Neurosci 2016; 27:63–67. https://doi.org/https://doi.org/10.1016/j.jocn.2015.08.036.

25.

Salonia R., Bell M. J., Kochanek P. M. The utility of near infrared spectroscopy in detecting intracranial hemorrhage in children. J Neurotrauma 2012;29:1047–1053. https://doi.org/https://doi.org/10.1089/neu.2011.1890.

26.

Hawthorne C., Shaw M., Piper I., Moss L. & Kinsella J. Transcranial bioimpedance measurement as a non-invasive estimate of intracranial pressure. Acta Neurochir Suppl 2018;126:89–92. https://doi.org/https://doi.org/10.1007/978-3-319-65798-1_19.

27.

Zeng X., Fhager A., Persson M. & Zirath H. Performance evaluation of a time-domain microwave system for medical diagnostics. IEEE Trans Instrum Meas 2019;68(8): 2880–2889. https://doi.org/https://doi.org/10.1109/TIM.2018.2867976.

28.

Stancombe A.E., Bialkowski K.S. & Abbosh A.M. Portable microwave head imaging system using software-defined radio and switching network. IEEE Journal of Electromagnetics, RF and Microwaves in Medicine and Biology 2019;3(4): 284–291. https://doi.org/https://doi.org/10.1109/JERM.2019.2901360.

29.

Gonzalez C. A., Valencia, J. A., Mora, A., et al. Volumetric electromagnetic phase-shift spectroscopy of brain edema and hematoma. PLoS One 2013; 8(5): e63223. https://doi.org/https://doi.org/10.1371/journal.pone.0063223.

30.

Oziel M., Hjouj M., Gonzalez C.A., Lavee J. & Rubinsky B. Non-ionizing radiofrequency electromagnetic waves traversing the head can be used to detect cerebrovascular autoregulation responses. Sci Rep 2016;6:23875. https://doi.org/https://doi.org/10.1038/srep21667.

31.

Rao C.P., Bershad E.M., Calvillo E., et al. Real-time noninvasive monitoring of intracranial fluid shifts during Dialysis using volumetric integral phase-shift spectroscopy (VIPS): a proof-of-concept study. Neurocrit Care 2018;28(1):117–126. https://doi.org/https://doi.org/10.1007/s12028-017-0409-4.

32.

Ljungqvist J., Candefjord S., Persson M., et al. Clinical evaluation of a microwave-based device for detection of traumatic intracranial hemorrhage. J Neurotrauma 2017;34(13):2176–2182. https://doi.org/https://doi.org/10.1089/neu.2016.4869.

33.

Kellner C.P., Sauvageau E., Snyder K.V., et al. The VITAL study and overall pooled analysis with the VIPS non-invasive stroke detection device. Journal of Neurointerventional Surgery 2018;10(11):1079–1084. https://doi.org/https://doi.org/10.1136/neurintsurg-2017-013690.

34.

Chen M., Yan Q., Sun J., et al. Investigating the relationship between cerebrospinal fluid and magnetic induction phase shift in rabbit Intracerebral hematoma expansion monitoring by MRI. Sci Rep 2017;7:11186. https://doi.org/https://doi.org/10.1038/s41598-017-11107-1.

35.

Xiong, Y., Mahmood, A. & Chopp, M. Animal models of traumatic brain injury. Nat Rev Neurosci 2013;14:128–142. https://doi.org/https://doi.org/10.1038/nrn3407.

36.

Oziel M., Korenstein R. & Rubinsky B. A brain phantom study of a noncontact single inductive coil device and the attendant algorithm for first stage diagnosis of internal bleeding in the head. Journal of Medical Devices 2020;14(1): 011102. https://doi.org/https://doi.org/10.1115/1.4045489.

37.

Oziel M., Hjouj M., Rubinsky B. & Korenstein R. Multifrequency analysis of single inductive coil measurements across a gel phantom simulation of internal bleeding in the brain. Bioelectromagnetics. 2019; 41(1): 21–33. https://doi.org/https://doi.org/10.1002/bem.22230.

38.

Munawar Qureshi A., Mustansar Z. & Mustafa S. Finite-element analysis of microwave scattering from a three-dimensional human head model for brain stroke detection. R Soc Open Sci 2018;5(7):180319. https://doi.org/https://doi.org/10.1098/rsos.180319.

39.

Conzen, C., Becker, K., Albanna, W. et al. The acute phase of experimental subarachnoid hemorrhage: intracranial pressure dynamics and their effect on cerebral blood flow and autoregulation. Transl Stroke Res 2019;10:566–582. https://doi.org/https://doi.org/10.1007/s12975-018-0674-3.

40.

Kasprowicz M, Lalou DA, Czosnyka M. Intracranial pressure, its components and cerebrospinal fluid pressure-volume compensation. Acta Neurol Scand. 2016;134(3):168–80. https://doi.org/134(3):168-180. https://doi.org/10.1111/ane.12541.CrossRefPubMed

41.

Cardim D., Robba C., Bohdanowicz M., et al. Non-invasive monitoring of intracranial pressure using Transcranial Doppler ultrasonography: is it possible?. Neurocrit Care 2016;25(3):473–491. https://doi.org/https://doi.org/10.1007/s12028-016-0258-6.

42.

Robba C, Regorio Santori G, Czosnyka M., et al. Optic nerve sheath diameter measured Sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 2018;44(8):1284–1294. https://doi.org/https://doi.org/10.1007/s00134-018-5305-7.

43.

Swanson J.W., Aleman T.S., Xu W., et al. Evaluation of optical coherence tomography to detect elevated intracranial pressure in children. JAMA Ophthalmol 2017;135(4):320–328. https://doi.org/https://doi.org/10.1001/jamaophthalmol.2017.0025.

Title: Noninvasive real-time assessment of intracranial pressure after traumatic brain injury based on electromagnetic coupling phase sensing technology
Authors: Gen Li
Wang Li
Jingbo Chen
Shuanglin Zhao
Zelin Bai
Qi Liu
Qi Liao
Minglian He
Wei Zhuang
Mingsheng Chen
Jian Sun
Yujie Chen
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Central Nervous System Trauma
Intracranial Hypertension
Published in: BMC Neurology / Issue 1/2021
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-021-02049-3

2024 ASCO Annual Meeting

Springer Medicine

Noninvasive real-time assessment of intracranial pressure after traumatic brain injury based on electromagnetic coupling phase sensing technology

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Impairment of the visuospatial working memory in the patients with Parkinson’s Disease: an fMRI study

Contrast-induced encephalopathy mimicking stroke after a second cerebral DSA: an unusual case report

Association between serum NLRP3 and malignant brain edema in patients with acute ischemic stroke

Factors associated with brain ageing - a systematic review

Safety and effectiveness of high flow extracranial to intracranial saphenous vein bypass grafting in the treatment of complex intracranial aneurysms: a single-centre long-term retrospective study

Validity and reliability of the medial temporal lobe atrophy scale in a memory clinic population